What is hepatitis?

“Hepatitis” means inflammation of the liver. Toxins, certain drugs,
some diseases, heavy alcohol use, and bacterial and viral infections can
all cause hepatitis. Hepatitis is also the name of a family of viral
infections that affect the liver; the most common types are Hepatitis A, Hepatitis B, and Hepatitis C.

What is the difference between Hepatitis A, Hepatitis B, and Hepatitis C?

Hepatitis A, Hepatitis B, C D, E and G Overview

Hepatitis A, Hepatitis B, and Hepatitis C
are diseases caused by three different viruses. Although each can cause
similar symptoms, they have different modes of transmission and can
affect the liver differently. Hepatitis A appears only as an acute or
newly occurring infection and does not become chronic. People with
Hepatitis A usually improve without treatment. Hepatitis B and Hepatitis
C can also begin as acute infections, but in some people, the virus
remains in the body, resulting in chronic disease and long-term liver
problems. There are vaccines to prevent Hepatitis A and B; however,
there is not one for Hepatitis C. If a person has had one type of viral
hepatitis in the past, it is still possible to get the other types.

What is Hepatitis C?

Hepatitis C is a contagious liver disease that ranges in severity
from a mild illness lasting a few weeks to a serious, lifelong illness
that attacks the liver. It results from infection with the Hepatitis C
virus (HCV), which is spread primarily through contact with the blood of
an infected person. Hepatitis C can be either “acute” or “chronic.”

Acute Hepatitis C virus infection is a short-term
illness that occurs within the first 6 months after someone is exposed
to the Hepatitis C virus. For most people, acute infection leads to
chronic infection.Chronic Hepatitis C virus infection is a long-term
illness that occurs when the Hepatitis C virus remains in a person’s
body. Hepatitis C virus infection can last a lifetime and lead to
serious liver problems, including cirrhosis (scarring of the liver) or
liver cancer.

Statistics

How common is acute Hepatitis C in the United States?

In 2013, there were an estimated 29,718 cases of acute hepatitis C virus infections reported in the United States.

How common is chronic Hepatitis C in the United States?

An estimated 2.7 million persons in the United States have chronic
hepatitis C virus infection. Most people do not know they are infected
because they don’t look or feel sick.

How likely is it that acute Hepatitis C will become chronic?

Approximately 75%–85% of people who become infected with Hepatitis C virus develop chronic infection.

Transmission / Exposure

How is Hepatitis C spread?

Hepatitis C is usually spread when blood from a person infected with the
Hepatitis C virus enters the body of someone who is not infected.
Today, most people become infected with the Hepatitis C virus by sharing
needles or other equipment to inject drugs. Before 1992, when
widespread screening of the blood supply began in the United States,
Hepatitis C was also commonly spread through blood transfusions and
organ transplants.

People can become infected with the Hepatitis C virus during such activities as

Sharing needles, syringes, or other equipment to inject drugs

Needlestick injuries in health care settings

Being born to a mother who has Hepatitis C

Less commonly, a person can also get Hepatitis C virus infection through

Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes

Having sexual contact with a person infected with the Hepatitis C virus

Can Hepatitis C be spread through sexual contact?

Yes, but the risk of transmission from sexual contact is believed to
be low. The risk increases for those who have multiple sex partners,
have a sexually transmitted disease, engage in rough sex, or are
infected with HIV. More research is needed to better understand how and
when Hepatitis C can be spread through sexual contact.

Can you get Hepatitis C by getting a tattoo or piercing?

A few major research studies have not shown Hepatitis C to be spread
through licensed, commercial tattooing facilities. However, transmission
of Hepatitis C (and other infectious diseases) is possible when poor
infection-control practices are used during tattooing or piercing. Body
art is becoming increasingly popular in the United States, and
unregulated tattooing and piercing are known to occur in prisons and
other informal or unregulated settings. Further research is needed to
determine if these types of settings and exposures are responsible for
Hepatitis C virus transmission.

Can Hepatitis C be spread within a household?

Yes, but this does not occur very often. If Hepatitis C virus is
spread within a household, it is most likely a result of direct,
through-the-skin exposure to the blood of an infected household member.

How should blood spills be cleaned from surfaces to make sure that Hepatitis C virus is gone?

Any blood spills — including dried blood, which can still be
infectious — should be cleaned using a dilution of one part household
bleach to 10 parts water. Gloves should be worn when cleaning up blood
spills.

How long does the Hepatitis C virus survive outside the body?

The Hepatitis C virus can survive outside the body at room temperature, on environmental surfaces, for up to 3 weeks.

What are ways Hepatitis C is not spread?

Hepatitis C virus is not spread by sharing eating utensils,
breastfeeding, hugging, kissing, holding hands, coughing, or sneezing.
It is also not spread through food or water.

Who is at risk for Hepatitis C?

Some people are at increased risk for Hepatitis C, including:

Current injection drug users (currently the most common way Hepatitis C virus is spread in the United States)

Past injection drug users, including those who injected only one time or many years ago

Recipients of donated blood, blood products, and organs (once a
common means of transmission but now rare in the United States since
blood screening became available in 1992)

People who received a blood product for clotting problems made before 1987

Hemodialysis patients or persons who spent many years on dialysis for kidney failure

People who received body piercing or tattoos done with non-sterile instruments

People with known exposures to the Hepatitis C virus, such as

Health care workers injured by needlesticks

Recipients of blood or organs from a donor who tested positive for the Hepatitis C virus

HIV-infected persons

Children born to mothers infected with the Hepatitis C virus

Less common risks include:

Having sexual contact with a person who is infected with the Hepatitis C virus

Sharing personal care items, such as razors or toothbrushes, that may have come in contact with the blood of an infected person

What is the risk of a pregnant woman passing Hepatitis C to her baby?

Hepatitis C is rarely passed from a pregnant woman to her baby. About
6 of every 100 infants born to mothers with Hepatitis C become infected
with the virus. However, the risk becomes greater if the mother has
both HIV infection and Hepatitis C.

Can a person get Hepatitis C from a mosquito or other insect bite?

Hepatitis C virus has not been shown to be transmitted by mosquitoes or other insects.

Can I donate blood, organs, or semen if I have Hepatitis C?

No, if you ever tested positive for the Hepatitis C virus (or
Hepatitis B virus), experts recommend never donating blood, organs, or
semen because this can spread the infection to the recipient.

Symptoms

What are the symptoms of acute Hepatitis C?

Approximately 70%–80% of people with acute
Hepatitis C do not have any symptoms. Some people, however, can have
mild to severe symptoms soon after being infected, including:

Fever

Fatigue

Loss of appetite

Nausea

Vomiting

Abdominal pain

Dark urine

Clay-colored bowel movements

Joint pain

Jaundice (yellow color in the skin or eyes)

How soon after exposure to Hepatitis C do symptoms appear?

If symptoms occur, the average time is 6–7 weeks after exposure, but
this can range from 2 weeks to 6 months. However, many people infected
with the Hepatitis C virus do not develop symptoms.

Can a person spread Hepatitis C without having symptoms?

Yes, even if a person with Hepatitis C has no symptoms, he or she can still spread the virus to others.

Is it possible to have Hepatitis C and not know it?

Yes, many people who are infected with the Hepatitis C virus do not
know they are infected because they do not look or feel sick.

What are the symptoms of chronic Hepatitis C?

Most people with chronic Hepatitis C do not have any symptoms.
However, if a person has been infected for many years, his or her liver
may be damaged. In many cases, there are no symptoms of the disease
until liver problems have developed. In persons without symptoms,
Hepatitis C is often detected during routine blood tests to measure
liver function and liver enzyme (protein produced by the liver) level.

How serious is chronic Hepatitis C?

Chronic Hepatitis C is a serious disease that can result in long-term
health problems, including liver damage, liver failure, liver cancer,
or even death. It is the leading cause of cirrhosis and liver cancer and
the most common reason for liver transplantation in the United States.
Approximately 15,000 people die every year from Hepatitis C related
liver disease.

What are the long-term effects of Hepatitis C?

5–20 people will go on to develop cirrhosis over a period of 20–30 years

1–5 people will die from cirrhosis or liver cancer

Tests

Can a person have normal liver enzyme (e.g., ALT) results and still have Hepatitis C?

Yes. It is common for persons with chronic Hepatitis C to have a
liver enzyme level that goes up and down, with periodic returns to
normal or near normal. Some infected persons have liver enzyme levels
that are normal for over a year even though they have chronic liver
disease. If the liver enzyme level is normal, persons should have their
enzyme level re-checked several times over a 6–12 month period. If the
liver enzyme level remains normal, the doctor may check it less
frequently, such as once a year.

Who should get tested for Hepatitis C?

Talk to your doctor about being tested for Hepatitis C if any of the following are true:

You were born from 1945 through 1965

You are a current or former injection drug user, even if you injected only one time or many years ago.

You were treated for a blood clotting problem before 1987.

You received a blood transfusion or organ transplant before July 1992.

You are on long-term hemodialysis treatment.

You have abnormal liver tests or liver disease.

You work in health care or public safety and were exposed to blood through a needlestick or other sharp object injury.

You are infected with HIV.

If you are pregnant, should you be tested for Hepatitis C?

No, getting tested for Hepatitis C is not part of routine prenatal care. However, if a pregnant woman has risk factors for Hepatitis C virus infection, she should speak with her doctor about getting tested.

What blood tests are used to test for Hepatitis C?

Several different blood tests are used to test for Hepatitis C. A
doctor may order just one or a combination of these tests. Typically, a
person will first get a screening test that will show whether he or she
has developed antibodies to the Hepatitis C virus. (An antibody is a
substance found in the blood that the body produces in response to a
virus.) Having a positive antibody test means that a person was exposed
to the virus at some time in his or her life. If the antibody test is
positive, a doctor will most likely order a second test to confirm
whether the virus is still present in the person's bloodstream.

Treatment

Can acute Hepatitis C be treated?

Yes, acute hepatitis C can be treated. Acute infection can clear on
its own without treatment in about 25% of people. If acute hepatitis C
is diagnosed, treatment does reduce the risk that acute hepatitis C will
become a chronic infection. Acute hepatitis C is treated with the same
medications used to treat chronic Hepatitis C. However, the optimal
treatment and when it should be started remains uncertain.

Can chronic Hepatitis C be treated?

Yes. There are several medications available to treat chronic
Hepatitis C, including new treatments that appear to be more effective
and have fewer side effects than previous options. The Food and Drug
Administration (FDA) maintains a complete list of approved treatments for Hepatitis C.

Is it possible to get over Hepatitis C?

Yes, approximately 15%–25% of people who get Hepatitis C will clear
the virus from their bodies without treatment and will not develop
chronic infection. Experts do not fully understand why this happens for
some people.

What can a person with chronic Hepatitis C do to take care of his or her liver?

People with chronic Hepatitis C should be monitored regularly by an
experienced doctor. They should avoid alcohol because it can cause
additional liver damage. They also should check with a health
professional before taking any prescription pills, supplements, or
over-the-counter medications, as these can potentially damage the liver.
If liver damage is present, a person should check with his or her
doctor about getting vaccinated against Hepatitis A and Hepatitis B.

Vaccination

Is there a vaccine that can prevent Hepatitis C?

Not yet. Vaccines are available only for Hepatitis A and Hepatitis B. Research into the development of a vaccine is under way.

Hepatitis C and Employment

Should a person infected with the Hepatitis C virus be restricted from working in certain jobs or settings?

CDC's recommendations
for prevention and control of the Hepatitis C virus infection state
that people should not be excluded from work, school, play, child care,
or other settings because they have Hepatitis C. There is no evidence
that people can get Hepatitis C from food handlers, teachers, or other
service providers without blood-to-blood contact.